Background
It is well known that the use of new technologies improves efficiency and safety in medicines management in hospitals. These include computerised physician order entry (CPOE) linked to decision support systems (DSSs), automated dispensing systems (ADSs), medicines administration records (MARs) and bar coding systems (BCSs) for drug administration.
Purpose
To survey the degree of incorporation of new technologies in key steps of the medicines use process: prescribing-validating, dispensing and administration of drugs in a 950-bed university hospital.
Materials and methods
CPOE is now in use for prescribing - validating, ADSs for dispensing and MARs-BCSs for drug administration processes.
According with the 2015 Initiative of the American Society of Hospital Pharmacy, the scoring criteria were Levels A, B, C or D if the goal was achieved, partially achieved, being implemented or not considered, respectively. The results obtained in 2005 and 2013 were compared.
Results
2005: 100% level D.
2013: 21.2% level A, 17.5% B, 25.0% C and 36.2% D.
In the medicines use process, in 2013 we found:
Prescribing-validating: CPOE-DSS (Silicon, GRIFOLS) was implemented in several areas of the hospital. 25% level A, 25% B and 50% C.
Dispensing: ADS (Kardex and Pyxis, GRIFOLS) were in use in the Pharmacy Department and several other hospital units. 60% level A, 20% B and 20% D.
Administration: MARs (Silicon) was partially implemented in several care units. 25% level B, 50% C and 25% D. Unfortunately, BCS for drug administration is not yet available in our hospital. 100% level D.
Conclusions
In order to improve safety in the administration of drugs, a bar coding system should be supplied to the different care units in the hospital.
Even so, the pharmacotherapeutic safety process has improved through implementation of computerised physician order entry linked with decision support systems and medicines administration records. In addition, medicines management is more efficient as we are using an automated medicines storage and dispensing system.
No conflict of interest.
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